Most women know about menopause—but not everyone talks about perimenopause, the stage before menopause when your body starts to change. It can feel confusing, frustrating, or even a bit scary at first. But the good news is: physiotherapy can help.

Let’s break it down.

What Is Perimenopause?

Perimenopause means “around menopause.” It’s the time when your hormones (especially estrogen and progesterone) start to change. This can last for several years before your periods stop completely.

When Does It Start?

Perimenopause usually begins in your 40s, but some women notice changes in their late 30s. It ends when you haven’t had a period for 12 months—that’s when you’ve officially reached menopause.

Signs You Might Be in Perimenopause

Everyone’s experience is different, but here are some common signs:

• Irregular periods (longer or shorter, heavier or lighter)

• Hot flashes or night sweats

• Mood swings, anxiety, or low mood

• Trouble sleeping

• Weight gain (especially around the belly)

• Fatigue or low energy

• Brain fog or forgetfulness

• Vaginal dryness or discomfort

• Bladder leaks or urgency

• Joint or muscle aches

If some of these sound familiar, you might be going through perimenopause.

How Can Physiotherapy Help?

You might be surprised to hear that physiotherapists—especially those trained in women’s health—can help with many of these symptoms. Here’s how:

1. Pelvic Floor Support

Hormone changes can weaken the pelvic floor muscles, leading to bladder leaks, heaviness, or discomfort. A physiotherapist can assess your pelvic floor and teach you exercises to strengthen and support it.

2. Bladder and Bowel Health

If you’re noticing more urgency, leaks, or trouble fully emptying your bladder, physio can help you retrain those muscles and improve your control.

3. Joint and Muscle Pain

Aching hips, knees, or back? Estrogen helps protect joints, so pain and stiffness are common during perimenopause. A physiotherapist can help with gentle strength exercises, stretching, and hands-on treatment to ease discomfort and keep you moving.

4. Exercise Guidance

Staying active is one of the best things you can do during perimenopause—but it’s not always easy when you’re tired or in pain. A physiotherapist can help you build a safe, enjoyable exercise plan that supports your muscles, bones, and mood.

5. Posture and Core Strength

Changes in hormones and muscle tone can affect your posture, leading to neck, back, or pelvic pain. Physio can help correct your posture and build core strength to reduce strain.

6. Support With Sleep and Stress

Poor sleep and high stress can make perimenopause symptoms worse. While physios can’t fix everything, they can teach relaxation techniques, breathing exercises, and gentle movement to help calm your nervous system and improve sleep.

Perimenopause is a natural stage of life—but that doesn’t mean you have to suffer through it. Physiotherapy can help you feel stronger, more comfortable, and more in control of your body.

If you think you might be in perimenopause and want support, book an appointment with one of our women’s health physiotherapists. You don’t have to go through it alone.